CAN TREAT: Identifying, understanding and addressing inequalities in CANcer TREATment

Start date

01 April 2025

End date

31 March 2031

Overview

Cancer is a leading cause of mortality in the United Kingdom. Chances for survival are improved when patients receive treatment (‘treatment receipt’), with further improvement when treatment is initiated early (shorter ‘time-to-treatment’).

Unfortunately, both are subject to inequalities, with individuals from marginalised groups being less likely to receive treatment/waiting longer to start treatment. The evidence for these inequalities, however, is limited, with little-to-no research conducted for specific cancers, treatments and marginalised groups, including many of the groups outlined in NHS England’s national framework for reducing health inequalities. Further, there is a lack of understanding as to why treatment inequalities exist, and how best to address them.

Aims and objectives

The aims of this research are to:

Identify which marginalised groups experience inequalities in treatment receipt and time-to-treatment, for which treatments, in relation to which cancers (Study 1)
Identify differences in cancer care experience (e.g., support from hospital staff), and the extent to which they mediate inequalities in treatment receipt and time-to-treatment (Study 2)
Understand how differences in cancer care experience, and wider factors, lead to treatment inequalities (Study 3)
Produce theory-based recommendations to inform the development of future interventions to reduce treatment inequalities (Study 3).

Study 1: Will be a matched cohort study, in which differences in treatment receipt and time-to-treatment will be compared between marginalised groups and matched cohorts, using linked data from the Clinical Practice Research Datalink, the Cancer Registry and Hospital Episode Statistics.

Study 2: Will also be a matched cohort study; however, in this study, differences in cancer care experience, and the extent to which they mediate treatment inequalities, will be assessed using data from the National Cancer Patient Experience Survey.

Study 3: Will comprise a series of qualitative studies, in which differences in cancer care experience (and wider factors), and how they lead to treatment inequalities, will be explored through interviews with patients and healthcare professionals. The data will be analysed using framework analysis, with the Theoretical Domains Framework used as the analytical framework. This will allow candidate behaviour change techniques, for future interventions, to be identified.

Funding amount

£716,923.18

Funder

Cancer Research UK

Privacy notice for study two

The role of inequalities in cancer care experience in mediating inequalities in cancer treatment receipt and time-to-treatment.

The aim of this study is to identify which marginalised groups are less likely to receive or wait longer to receive which treatments, in relation to which cancers, and the reasons why. This will allow us to make recommendations to cancer services, with a view of of making treatment more accessible / accessible faster to all.

The research

To identify which marginalised groups are less likely to receive or wait longer to receive treatments, in relation to which cancers, and the reasons why, we will look at data collected by NHS England.

Specifically, we will look at data from two datasets. The first dataset is referred to as the ‘Cancer Registration Dataset’. This dataset includes information on the treatment received by cancer patients living in England.

The second dataset is the ‘National Cancer Patient Experience Survey Dataset’. This dataset includes information on cancer patients’ experiences of being diagnosed with, and treated for, cancer. It also includes information on each patient’s characteristics, such as whether they have a learning disability, or severe mental illness.

By looking at these two datasets, we will be able to link the treatments patients’ received, and their experiences of receiving those treatments, with their protected characteristics.

This will allow us to see whether there are any differences in the treatments received by different groups of patients, and whether these differences are due to differences in their experiences of being diagnosed with / treated for cancer.

The purposes of the processing

The purpose of the study and processing of the data is to identify which marginalised groups are less likely to receive or wait longer to receive which treatments, in relation to which cancers, and the reasons why.

This will allow us to make recommendations to cancer services, with a view of of making treatment more accessible / accessible faster to all.